Integrated robotic insufflation and smoke evacuation

ABSTRACT

A surgical robotic system comprising: a robotic arm; a tool drive coupled to the robotic arm; a cannula interface configured to couple a cannula to the tool drive, the cannula interface having a fluid pathway in communication with an interior lumen of the cannula; and an insufflation pathway coupled to the robotic arm, the insufflation pathway having a distal end coupled to the fluid pathway and a proximal end coupled to a surgical insufflator.

BACKGROUND Field

Embodiments related surgical robotic systems, are disclosed. Moreparticularly, embodiments related to a surgical robotic arm with a fluidpathway integrated into the tool drive-cannula interface forinsufflation and smoke evacuation, are disclosed.

Background

Minimally-invasive surgery (MIS), such as endoscopic surgery, involveslooking into a patient's body and performing surgery inside the bodyusing endoscopes and other surgical tools. For example, laparoscopicsurgery can use a laparoscope to access and view an abdominal cavity.Endoscopic surgery can be performed using manual tools and/or a surgicalrobotic system having robotically-assisted tools. Access may be providedto the body cavity of a patient through a trocar. Once a distal end of acannula of the trocar is properly positioned and inserted through tissueand into an interior region of the patient, for example, through theabdominal wall of the patient, a surgical robotic arm having a trocardocking interface at its distal end, or a tool drive attached thereto,is manually maneuvered by a user until the docking interface is alignedwith an attachment portion (e.g., a mating cannula interface) on theproximal end of the trocar (outside the patient.) The user then latchesthe components to each other, either manually or as an automated step,thereby rigidly attaching the arm to the trocar. A surgical tool havingan end effector at its distal end (e.g., scissors, grasping jaws, orcamera) is then inserted into a top opening of the cannula and the toolis then attached to the arm such that further surgical operations can beperformed with the tool.

SUMMARY

Smoke is a common complaint in MIS because it obstructs visualization ofthe anatomy and makes performing surgical tasks difficult. In somecases, to address this issue, a surgical insufflator and/or smokeevacuation system may be used in addition to the surgical systemcomponents. The use of a separate insufflator and/or smoke evacuationsystem, however, increases procedural time and workflow difficultiesresulting in higher costs for the hospital. The instant inventionproposes a robotic arm with fluid pathways (e.g., insufflation tubing)integrated into components of the surgical system, for example, thesurgical robotic arm and an interface between the tool drive and acannula coupled to the tool drive. The fluid pathway and/or insufflationtubing is coupled to a pump (e.g., surgical insufflator) that can beused to control a flow of gas to/from the surgical site within which thecannula is positioned. The integrated pathways eliminate additionalworkflow operations (e.g., configuration of separate insufflationtubing) and improve user workflow and smoke evacuation, allowing forsignificantly improved surgical site visualization and improvedintraoperative performance.

Representatively, the overall system may include a robotic arm and acannula interface (e.g., at a proximal end of the trocar) used torigidly attach a cannula to a tool drive coupled to the robotic arm. Afluid pathway (e.g., port, tube, lumen, channel, or the like) thatallows for transmission of a fluid (e.g., insufflation gas) along therobotic arm, and directly to the cannula, is further integrated into thesystem. The integrated pathway may include, for example, an insufflationtube that is attached at one end to a surgical insufflator (e.g., a pumpfor controlling gas flow to/from the surgical site) and extends alongthe arm housing to the cannula interface. The end of the insufflationtube at the cannula interface side may be attached to a portion of theintegrated pathway formed through the cannula interface to the cannulalumen. In this way, a flow of fluid may be transmitted from the surgicalinsufflator to the surgical site within which the cannula is positioned,without having to attach a separate insufflation component to thesurgical robotic system. In addition, the direction of fluid flow may bereversed and the insufflation tube may be used to evacuate smoke fromthe surgical site. In still further aspects, there may be more than oneinsufflation tube and/or fluid pathways formed within the cannulainterface to facilitate gas transmission as desired. In some cases, theinsufflation tube and/or pathway may be coupled to a valve that enablesthe flow of fluid to be stopped as desired. In addition, in some aspectsinstead of directly integrating the insufflation tubing into the roboticarm, the insufflation tubing could be combined with a sterile drape. Thesurgical insufflator could also be integrated into the overall roboticsystem.

Additional configurations may include modes that dynamically adjustfluid inflow and outflow from each cannula of the system to addressvarious surgical conditions. For example, the system may include aprocessor configured to detect when a compatible energy device isactivated and then increase fluid outflow from the surgical site toremove smoke and particulate while simultaneously increasing inflow toprevent loss of pneumoperitoneum. To address fogging, the system coulddynamically switch which pathway or port has insufflation/smokeevacuation to move a flow of gas away from the endoscope. In addition,the system may include a heating element, for example incorporatedwithin the insufflation tubing, and a flow of heated gas could beswitched to the cannula with the endoscope to warm it and remove thefog. Still further, if particulate is detected on the endoscope or acamera, the system could increase a fluid outflow to the endoscope orcamera to blow particulate away from the instrument.

Representatively, in one aspect, a surgical robotic system includes arobotic arm; a tool drive coupled to the robotic arm; a cannulainterface configured to couple a cannula to the tool drive, the cannulainterface having a fluid pathway in communication with an interior lumenof the cannula; and an insufflation pathway coupled to the robotic arm,the insufflation pathway having a distal end coupled to the fluidpathway and a proximal end coupled to a surgical insufflator. The fluidpathway may be integrated within the cannula interface and dimensionedto allow transmission of an insufflation gas between the insufflationpathway and the interior lumen of the cannula. The tool drive mayinclude a docking interface and the insufflation pathway may be coupledto the docking interface. The interior lumen of the cannula may bedimensioned to receive a surgical tool.

The system may further include a filter in communication with the fluidpathway such that an insufflation gas transmitted through theinsufflation pathway to the fluid pathway passes through the filter. Thefilter may be integrated into a sterile adapter positioned between thetool drive and the cannula interface. A sealing element may further beintegrated into the sterile adapter to seal the filter between the tooldrive and the cannula interface and prevent leakage of the insufflationgas. In some aspects, the fluid pathway may be a first fluid pathway andthe insufflation pathway is a first insufflation pathway, and thesurgical robotic system may also include a second fluid pathway coupledto a second insufflation pathway. In some aspects, a valve is coupled toat least one of the first fluid pathway or the second fluid pathway tocontrol a flow of a fluid through the first fluid pathway or the secondfluid pathway. Still further, a nozzle may be coupled to the fluidpathway, and the nozzle may be configured to direct an insufflation gasflowing through the fluid pathway toward a surgical instrumentpositioned within the interior lumen of the cannula. The insufflationpathway may be an insufflation tube. The insufflation tube may beenclosed within an outer shell of the robotic arm. The insufflation tubemay be mechanically attached to an outer surface of an outer shell ofthe robotic arm.

In another aspect, a surgical robotic system includes a surgical roboticassembly having a robotic arm, a tool drive and a cannula interface forcoupling a cannula to the tool drive, the cannula interface having afluid pathway integrated therein that is in fluid communication with aninterior lumen of the cannula; an insufflation tube coupled to therobotic arm, the insufflation tube having a distal end coupled to thefluid pathway and a proximal end coupled to a surgical insufflator; anda processor communicatively coupled to the surgical robotic assembly andthe surgical insufflator, the processor operable to control an operationof the surgical insufflator based on a detected surgical condition. Insome aspects, the detected surgical condition is a presence of smokewithin a surgical site; and the operation controlled by the processor isa smoke evacuation function of the surgical insufflator. The smokeevacuation function may include actively evacuating smoke through theinsufflation tube while maintaining pneumoperitoneum at the surgicalsite. In some aspects, the fluid pathway is a first fluid pathway andthe insufflation tube is a first insufflation tube, and the surgicalrobotic assembly further comprises a second fluid pathway and a secondinsufflation tube that are not fluidly coupled to the surgicalinsufflator, and the smoke evacuation function comprise passivelyevacuating smoke through the second fluid pathway and secondinsufflation tube. In still further aspects, the robotic arm is a firstrobotic arm and the insufflation tube is a first insufflation tube, thesystem further comprising a second robotic arm and a second insufflationtube integrated with the second robotic arm, and the smoke evacuationfunction comprises introducing a flow of fluid to the surgical cavitythrough the first insufflation tube and evacuating smoke from thesurgical cavity using the second insufflation tube. In some cases, thedetected surgical condition may be activation of an energy device withina surgical site; and the operation controlled by the processor is asmoke evacuation function of the surgical insufflator. In other aspects,the detected surgical condition may be a presence of particles within asurgical site; and the operation controlled by the processor is aparticle removal function of the surgical insufflator.

The above summary does not include an exhaustive list of all aspects ofthe present invention. It is contemplated that the invention includesall systems and methods that can be practiced from all suitablecombinations of the various aspects summarized above, as well as thosedisclosed in the Detailed Description below and particularly pointed outin the claims filed with the application. Such combinations haveparticular advantages not specifically recited in the above summary.

BRIEF DESCRIPTION OF THE DRAWINGS

The embodiments of the invention are illustrated by way of example andnot by way of limitation in the figures of the accompanying drawings inwhich like references indicate similar elements. It should be noted thatreferences to “an” or “one” embodiment of the invention in thisdisclosure are not necessarily to the same embodiment, and they mean atleast one. Also, in the interest of conciseness and reducing the totalnumber of figures, a given figure may be used to illustrate the featuresof more than one embodiment of the invention, and not all elements inthe figure may be required for a given embodiment.

FIG. 1 is a pictorial view of an example surgical robotic system in anoperating arena, in accordance with an embodiment.

FIG. 2 is a perspective view of a portion of a robotic arm according toone aspect of the disclosure.

FIG. 3 is a schematic perspective view of a tool drive of the roboticarm of FIG. 2.

FIG. 4 is a cross-sectional side view of a tool drive and a cannulaassociated with the trocar of FIG. 3.

FIG. 5 is a cross-sectional side view of a tool drive and a cannulaassociated with the trocar of FIG. 3.

FIG. 6 is a cross-sectional side view of a tool drive and a cannulaassociated with the trocar of FIG. 3.

FIG. 7 is a cross-sectional side view of a tool drive and a cannulaassociated with the trocar of FIG. 3.

FIG. 8 is a cross-sectional side view of a tool drive and a cannulaassociated with the trocar of FIG. 3.

FIG. 9 is a cross-sectional side view of a tool drive and a cannulaassociated with the trocar of FIG. 3.

FIG. 10 is a block diagram of an exemplary processing operation of asurgical robotic system, in accordance with an embodiment.

FIG. 11 is a block diagram of a computer portion of a surgical roboticsystem, in accordance with an embodiment.

DETAILED DESCRIPTION

In various embodiments, description is made with reference to thefigures. However, certain embodiments may be practiced without one ormore of these specific details, or in combination with other knownmethods and configurations. In the following description, numerousspecific details are set forth, such as specific configurations,dimensions, and processes, in order to provide a thorough understandingof the embodiments. In other instances, well-known processes andmanufacturing techniques have not been described in particular detail inorder to not unnecessarily obscure the description. Reference throughoutthis specification to “one embodiment,” “an embodiment,” or the like,means that a particular feature, structure, configuration, orcharacteristic described is included in at least one embodiment. Thus,the appearance of the phrase “one embodiment,” “an embodiment,” or thelike, in various places throughout this specification are notnecessarily referring to the same embodiment. Furthermore, theparticular features, structures, configurations, or characteristics maybe combined in any suitable manner in one or more embodiments.

In addition, the terminology used herein is for the purpose ofdescribing particular aspects only and is not intended to be limiting ofthe invention. Spatially relative terms, such as “beneath”, “below”,“lower”, “above”, “upper”, and the like may be used herein for ease ofdescription to describe one element's or feature's relationship toanother element(s) or feature(s) as illustrated in the figures. It willbe understood that the spatially relative terms are intended toencompass different orientations of the device in use or operation inaddition to the orientation depicted in the figures. For example, if thedevice in the figures is turned over, elements described as “below” or“beneath” other elements or features would then be oriented “above” theother elements or features. Thus, the exemplary term “below” canencompass both an orientation of above and below. The device may beotherwise oriented (e.g., rotated 90 degrees or at other orientations)and the spatially relative descriptors used herein interpretedaccordingly.

As used herein, the singular forms “a”, “an”, and “the” are intended toinclude the plural forms as well, unless the context indicatesotherwise. It will be further understood that the terms “comprises”and/or “comprising” specify the presence of stated features, steps,operations, elements, and/or components, but do not preclude thepresence or addition of one or more other features, steps, operations,elements, components, and/or groups thereof.

The terms “or” and “and/or” as used herein are to be interpreted asinclusive or meaning any one or any combination. Therefore, “A, B or C”or “A, B and/or C” mean “any of the following: A; B; C; A and B; A andC; B and C; A, B and C.” An exception to this definition will occur onlywhen a combination of elements, functions, steps or acts are in some wayinherently mutually exclusive.

Moreover, the use of relative terms throughout the description maydenote a relative position or direction. For example, “distal” mayindicate a first direction away from a reference point, e.g., away froma user. Similarly, “proximal” may indicate a location in a seconddirection opposite to the first direction, e.g., toward the user. Suchterms are provided to establish relative frames of reference, however,and are not intended to limit the use or orientation of any particularsurgical robotic component to a specific configuration described in thevarious embodiments below.

Referring to FIG. 1, this is a pictorial view of an example surgicalrobotic system 100 in an operating arena. The surgical robotic system100 includes a user console 102, a control tower 103, and one or moresurgical robots 120, including robotic arms 104 at a surgical roboticplatform 105, e.g., an operating table, a bed, etc. The system 100 canincorporate any number of devices, tools, or accessories used to performsurgery on a patient 106. For example, the system 100 may include one ormore surgical tools 107 used to perform surgery. A surgical tool 107 maybe an end effector that is attached to a distal end of a surgical arm104, for executing a surgical procedure.

Each surgical tool 107 may be manipulated manually, robotically, orboth, during the surgery. For example, the surgical tool 107 may be atool used to enter, view, or manipulate an internal anatomy of thepatient 106. In an embodiment, the surgical tool 107 is a grasper thatcan grasp tissue of the patient. The surgical tool 107 may be controlledmanually, by a bedside operator 108; or it may be controlledrobotically, via actuated movement of the surgical robotic arm 104 towhich it is attached. The surgical robotic arms 104 are shown as atable-mounted system, but in other configurations the surgical roboticarms 104 may be mounted in a cart, ceiling or sidewall, or in anothersuitable structural support.

Generally, a remote operator 109, such as a surgeon or other operator,may use the user console 102 to remotely manipulate the surgical roboticarms 104 and/or the attached surgical tools 107, e.g., teleoperation.The user console 102 may be located in the same operating room as therest of the system 100, as shown in FIG. 1. In other environmentshowever, the user console 102 may be located in an adjacent or nearbyroom, or it may be at a remote location, e.g., in a different building,city, or country. The user console 102 may comprise a seat 110, one ormore user interface devices, for example, foot-operated controls 113 orhandheld user input devices (UID) 114, and at least one user display 115that is configured to display, for example, a view of the surgical siteinside the patient 106. In the example user console 102, the remoteoperator 109 is sitting in the seat 110 and viewing the user display 115while manipulating a foot-operated control 113 and a handheld UID 114 inorder to remotely control the arms 104 and the surgical tools 107 (thatare mounted on the distal ends of the arms 104).

In some variations, the bedside operator 108 may also operate the system100 in an “over the bed” mode, in which the bedside operator 108 (user)is now at a side of the patient 106 and is simultaneously manipulating arobotically-driven tool (end effector as attached to the arm 104), e.g.,with a handheld UID 114 held in one hand, and a manual laparoscopictool. For example, the bedside operator's left hand may be manipulatingthe handheld UID to control a robotic component, while the bedsideoperator's right hand may be manipulating a manual laparoscopic tool.Thus, in these variations, the bedside operator 108 may perform bothrobotic-assisted minimally invasive surgery and manual laparoscopicsurgery on the patient 106.

During an example procedure (surgery), the patient 106 is prepped anddraped in a sterile fashion to achieve anesthesia. Initial access to thesurgical site may be performed manually while the arms of the roboticsystem 100 are in a stowed configuration or withdrawn configuration (tofacilitate access to the surgical site.) Once access is completed,initial positioning or preparation of the robotic system 100 includingits arms 104 may be performed. Next, the surgery proceeds with theremote operator 109 at the user console 102 utilizing the foot-operatedcontrols 113 and the UIDs 114 to manipulate the various end effectorsand perhaps an imaging system, to perform the surgery. Manual assistancemay also be provided at the procedure bed or table, by sterile-gownedbedside personnel, e.g., the bedside operator 108 who may perform taskssuch as retracting tissues, performing manual repositioning, and toolexchange upon one or more of the robotic arms 104. Non-sterile personnelmay also be present to assist the remote operator 109 at the userconsole 102. When the procedure or surgery is completed, the system 100and the user console 102 may be configured or set in a state tofacilitate post-operative procedures such as cleaning or sterilisationand healthcare record entry or printout via the user console 102.

In one embodiment, the remote operator 109 holds and moves the UID 114to provide an input command to move a robot arm actuator 117 in therobotic system 100. The UID 114 may be communicatively coupled to therest of the robotic system 100, e.g., via a console computer system 116.Representatively, in some embodiments, UID 114 may be a portablehandheld user input device or controller that is ungrounded with respectto another component of the surgical robotic system. For example, UID114 may be ungrounded while either tethered or untethered from the userconsole. The term “ungrounded” is intended to refer to implementationswhere, for example, both UIDs are neither mechanically nor kinematicallyconstrained with respect to the user console. For example, a user mayhold a UID 114 in a hand and move freely to any possible position andorientation within space only limited by, for example, a trackingmechanism of the user console. The UID 114 can generate spatial statesignals corresponding to movement of the UID 114, e.g. position andorientation of the handheld housing of the UID, and the spatial statesignals may be input signals to control a motion of the robot armactuator 117. The robotic system 100 may use control signals derivedfrom the spatial state signals, to control proportional motion of theactuator 117. In one embodiment, a console processor of the consolecomputer system 116 receives the spatial state signals and generates thecorresponding control signals. Based on these control signals, whichcontrol how the actuator 117 is energized to move a segment or link ofthe arm 104, the movement of a corresponding surgical tool that isattached to the arm may mimic the movement of the UID 114. Similarly,interaction between the remote operator 109 and the UID 114 can generatefor example a grip control signal that causes a jaw of a grasper of thesurgical tool 107 to close and grip the tissue of patient 106.

The surgical robotic system 100 may include several UIDs 114, whererespective control signals are generated for each UID that control theactuators and the surgical tool (end effector) of a respective arm 104.For example, the remote operator 109 may move a first UID 114 to controlthe motion of an actuator 117 that is in a left robotic arm, where theactuator responds by moving linkages, gears, etc., in that arm 104.Similarly, movement of a second UID 114 by the remote operator 109controls the motion of another actuator 117, which in turn moves otherlinkages, gears, etc., of the robotic system 100. The robotic system 100may include a right arm 104 that is secured to the bed or table to theright side of the patient, and a left arm 104 that is at the left sideof the patient. An actuator 117 may include one or more motors that arecontrolled so that they drive the rotation of a joint of the arm 104, tofor example change, relative to the patient, an orientation of anendoscope or a grasper of the surgical tool 107 that is attached to thatarm. Motion of several actuators 117 in the same arm 104 can becontrolled by the spatial state signals generated from a particular UID114. The UIDs 114 can also control motion of respective surgical toolgraspers. For example, each UID 114 can generate a respective gripsignal to control motion of an actuator, e.g., a linear actuator, thatopens or closes jaws of the grasper at a distal end of surgical tool 107to grip tissue within patient 106.

In some aspects, the communication between the platform 105 and the userconsole 102 may be through a control tower 103, which may translate usercommands that are received from the user console 102 (and moreparticularly from the console computer system 116) into robotic controlcommands that are transmitted to the arms 104 on the robotic platform105. The control tower 103 may also transmit status and feedback fromthe platform 105 back to the user console 102. The communicationconnections between the robotic platform 105, the user console 102, andthe control tower 103 may be via wired and/or wireless links, using anysuitable ones of a variety of data communication protocols. Any wiredconnections may be optionally built into the floor and/or walls orceiling of the operating room. The robotic system 100 may provide videooutput to one or more displays, including displays within the operatingroom as well as remote displays that are accessible via the Internet orother networks. The video output or feed may also be encrypted to ensureprivacy and all or portions of the video output may be saved to a serveror electronic healthcare record system. It will be appreciated that theoperating room scene in FIG. 1 is illustrative and may not accuratelyrepresent certain medical practices.

Turning to FIG. 2, a portion of a robotic arm 104 is illustratedaccording to one aspect of the disclosure. The robotic arm 104 andassociated components described herein can form a surgical roboticsystem according to an embodiment of the disclosure. The robotic arm 104can be incorporated into the surgical robotic system 100 described inreference to FIG. 1, or can form a portion of a different system. Whilea single robotic arm 104 is illustrated, it will be understood that therobotic arm 104 can include additional arm portions or can be acomponent of a multi-arm apparatus without departing from thedisclosure.

The robotic arm 104 may include a plurality of links (e.g., links202A-202E) and a plurality of joint modules (e.g., joints 204A-204E) foractuating the plurality of links relative to one another. The jointmodules can include various joint types, such as a pitch joint or a rolljoint, any of which can be actuated manually or by the robotic armactuators 117, and any of which may substantially constrain the movementof the adjacent links around certain axes relative to others. As alsoshown, a tool drive 206 is attached to the distal end of the robotic arm104. As described herein, the tool drive 206 can be configured with adocking interface 208 to receive an attachment portion (e.g., a matingcannula interface at a proximal end of the trocar) of a trocar 210 suchthat one or more surgical instruments (e.g., endoscopes, staplers, etc.)can be guided through a lumen of the cannula of the trocar 210. Theplurality of the joint modules 204A-204E of the robotic arm 104 can beactuated to position and orient the tool drive 206 for roboticsurgeries.

A fluid pathway 212 for controlling a flow of fluid to/from a surgicalsite or surgical cavity within which the trocar 210 is positioned, isalso shown. The fluid pathway 212 may be integrated with, attached to,or otherwise formed as part of, the robotic arm 104. The fluid pathway212 may be coupled to a pump assembly 214, for example an insufflationpump, and therefore also be referred to herein as an insufflationpathway. For example, at least a portion of the fluid pathway 212 may bean insufflation tube (e.g., insufflation pathway) that is connected tothe pump 214 and runs along an entire length of the robotic arm 104. Theinsufflation tube may be enclosed within the cosmetic panels 216 formingthe arm 104. For example, the insufflation tube may be mechanicallyattached (e.g., clamp, clip, bolt, bracket, fastener, or the like) to aninner surface of the panels 216, or may be positioned within tubereceiving channels formed within the inner surface of the panels 216.Alternatively, the insufflation tube may be connected to an exteriorsurface of the panels 216 forming the arm 104. For example, theinsufflation tube may be mechanically attached to the exterior surfaceby bands, ties, or the like. A proximal end 220 of fluid pathway 212 maybe attached to the pump assembly 214, for example a surgicalinsufflator, that controls the flow of fluid through the pathway 212. Adistal end 222 of the fluid pathway 212 may be attached to the cannulaassociated with the trocar 210. The pump assembly 214 may control thedirection of fluid flow through the pathway 212 to allow for smokeevacuation, particulate removal, pneumoperitoneum, or management ofother conditions within the associated surgical site or surgical cavityduring the surgical procedure.

FIG. 3 is a schematic diagram illustrating an exemplary tool drive 206without a loaded tool in accordance with aspects of the subjecttechnology. In one variation, the tool drive 206 may include anelongated base (or “stage”) 302 having longitudinal tracks 304 and atool carriage 306, which is slidingly engaged with the longitudinaltracks 304. The stage 302 may be configured to couple to the distal endof a robotic arm 104 (see FIG. 2) such that articulation of the roboticarm 104 positions and/or orients the tool drive 206 in space. The toolcarriage 306 may be configured to receive a tool that extends throughthe trocar 210.

Additionally, the tool carriage 306 may actuate a set of articulatedmovements through a cable system or wires manipulated and controlled byactuated drives (the terms “cable” and “wire” are used interchangeablythroughout this application). The tool carriage 306 may includedifferent configurations of actuated drives, such as a mechanicaltransmission. The trocar 210 can be coupled to the tool drive 206, oranother component of the surgical robotic system 100, at a dockingstation or docking interface 208 located at a distal block of theelongated base 302. The docking interface 208 is configured to receive aportion of the trocar 210 such that the docking interface 208 isconfigured as a trocar docking interface, a trocar attachment device, ora trocar mounting device. The docking interface 208 can provide areliable and quick way to attach the trocar 210 to the surgical roboticsystem 100. For example, although not shown, the docking interface 208can define a receiving space for receiving a portion of the trocar 210(e.g., a cannula interface at a proximal end of trocar). Once inposition, the docking interface 208 and trocar 210 may be held in placerelative to one another using a clamping assembly. In some variations,the docking interface 208 may also provide a sterile barrier betweensterile components such as the trocar 210 and non-sterile components onthe other side of the docking interface. The sterile barrier may beprovided, for example, by a sterile adapter formed of a surgical-gradepolymer or other surgical-grade material that is interposed between thetrocar 210 and the docking interface 208 (as will be described in moredetail in reference to FIG. 4).

In addition, it can further be seen from this view that the fluidpathway 212 extends along the robotic arm link 202E (e.g., attached tothe interior or exterior surface of the link panel) to the dockinginterface 208. The distal end of the fluid pathway 212 is further showndirectly connecting to a cannula of the trocar 210, as will now bedescribed in more detail in reference to FIG. 4. Representatively, FIG.4 is a cross-sectional side view of the interface between the tool driveand a cannula of the trocar assembly described in FIG. 3. From thisview, it can be seen that pathway 212 is integrated into robotic armlink 202E and docking interface 208. For example, pathway 212 may beformed by an insufflation tube mounted to, or integrally formed with,the exterior and/or interior surface of link 202E and docking interface208. It is further contemplated that, in some aspects, at least aportion of pathway 212 may be a channel formed through link 202E and/orinterface 208, that allows for fluid transmission alone, or incombination with, for example, an insufflation tube. The portion ofpathway 212 directly coupled to link 202E may terminate at a distal endor portion 422 of docking interface 208.

A cannula 402 (with the remaining trocar components removed for ease ofillustration) is further shown including a cannula interface 404, whichis received by docking interface 208, to secure the two componentstogether. Cannula interface 404 may be a protruding or extended portion(e.g. a lug) of cannula 402 (e.g., located at a proximal end of thetrocar) that is suitable for insertion within a receiving portion orcavity 414 formed in the distal end of docking interface 208. Thecannula interface 404 includes an integrated fluid pathway 408 (e.g., acannula side pathway) that connects the fluid pathway 212 (e.g., thetool drive side pathway) to the cannula 402. Representatively, cannulainterface 404 may include pathway 408 formed by a channel withininterface 404. The channel may extend between a fluid port 406 (e.g.,tool drive side port) at a proximal end 424 of the cannula interface 404and a fluid port 410 (e.g., cannula side port) at a distal end 426 ofthe cannula interface 404. Fluid port 410 opens to the lumen 412 ofcannula 402 and fluid port 406 opens to an external environmentsurrounding the cannula. When cannula interface 404 is engaged with thedocking interface 208, fluid port 406 becomes aligned with, and fluidlycoupled to, the pathway 212 (e.g. on the tool drive side) such that afluid (e.g., insufflation gas) can travel along pathways 212, 408to/from the lumen 412 of cannula 402, as shown by arrow 430. The lumen412 of cannula 402 extends to the surgical site or cavity so that thefluid traveling through pathways 212, 408 is transmitted to/from thecavity depending on the desired operation (e.g., insufflation, smokeevacuation, particular removal, etc). It can further be understood fromthis view that the integrated pathways 212, 408 may be in communicationwith the same cannula lumen 412 within which a surgical tool may bepositioned. In other words, a fluid(s) traveling between pathways 212,408 and the surgical cavity may use a same pathway as the surgical tool,as opposed to forming a separate pathway through the cannula 402.

In some aspects, a sterile adapter 414 may be positioned between cannulainterface 404 and docking interface 208 to create a sterile barrieraround cannula 402. The sterile adapter 414 may include an adapteropening 428 that is aligned with the pathways 212, 408, when cannulainterface 404 is connected with docking interface 208, to allow for thetransmission of fluid to the cannula 402, as previously discussed. Afilter 428 could further be positioned between cannula interface 404 anddocking interface 208. For example, filter 428 could be part of, orotherwise coupled to, sterile adapter 414. Filter 428 may be incommunication with pathways 212, 408 so that it filters the fluidtransmitted through pathways 212, 408. For example, filter 428 could bea filter which blocks particulates or other non-sterile matter from thesurgical cavity from contaminating the pathway 212 so that the roboticside of the pathway (e.g., insufflation tubing) can be used for anentire day of procedures and only the adapter 414 and cannula 402 needto be replaced between patients. In addition, a seal 416 for sealing theadapter 414 and/or filter 428 between the docking and cannula interfaces208, 404 may further be provided. For example, the seal 416 may be ano-ring or similar type structure that is coupled to the adapter opening428 and integrated within, or otherwise forms part of, the sterileadapter 414.

In still further aspects, it is contemplated that an optional nozzle 440may further be provided to control and/or direct a fluid flow throughpathways 212, 408. For example, nozzle 440 may be formed at the dockingand cannula interface 208, 404. Representatively, nozzle 440 may be aprotruding portion or spout that is formed at the distal end 422 ofdocking interface 208 and/or pathway 212. The proximal end of cannulainterface 404, which engages docking interface 208, may have recessedportion 442 that is dimensioned to receive nozzle 440 therein. Thenozzle 440 may be used to stop the flow of an insufflation gas throughpathway 212 of docking interface 208 to pathway 408 of cannula interface408. Nozzle 440 may be integrally formed with pathway 212, or a separatepiece attached to pathway 212. Nozzle 440 may have any shape, sizeand/or configuration suitable for controlling and/or directing a flow offluid through pathways 212, 408.

In other aspects, nozzle 440 may be omitted. Representatively, FIG. 5shows a configuration in which the nozzle is omitted and the interface208 and cannula interface 404 are substantially flat. Representatively,FIG. 5 is a cross-sectional side view of the robotic arm link 202E,docking interface and cannula 402 of FIG. 4, except that the interfacingsides of docking interface 208 and cannula interface 404 are flat,planar, or otherwise flush, with one another and nozzle 440 is omitted.The remaining components of the tool drive and cannula interface of FIG.5 are the same as those described in reference to FIG. 4.

Returning now to FIG. 4, additional aspects of cannula 402 may include acannula seal 420. The cannula seal 420 may seal the cannula lumen 412from the ambient environment so that the fluid flow in/out of thecannula lumen 412 is prevented from entering the ambient environment.Cannula seal 420 may, however, allow for a surgical tool to be insertedinto cannula 402, and once inserted, may seal around the tool so thatthe fluid does not leak around the tool. For example, cannula seal 420may include a valve which allows for the insertion and/or removal of asurgical tool but will not open in response to a pressure from the fluidbeing transmitted in/out of the cannula lumen 412.

FIG. 6 is a cross-sectional side view of a tool drive and cannulainterface according to another aspect of the invention. The tool driveand cannula interface of FIG. 6 is substantially similar to that ofFIGS. 4-5 in that it includes a robotic arm link 202E and dockinginterface 208 that connects with, or interfaces with, the cannulainterface 404 of cannula 402 as previously discussed. In this aspect,however, the assembly includes two integrated fluid pathways 602A, 602Bfor input/output of a fluid between the pump (not shown) and cannula402. In particular, the assembly includes a first fluid pathway 602Awhich includes a fluid pathway 212A integrated with the robotic arm link202E and docking interface 208 (e.g., the tool drive side pathway) andfluid pathway 408A integrated with the cannula interface 404 (e.g., thecannula side pathway). Fluid pathway 408A extends between a fluid port406A at a proximal end of the cannula interface 404 and a fluid port410A at a distal end of the cannula interface 404. Fluid port 406A is influid communication with the fluid pathway 212A while fluid port 410A isin fluid communication with the cannula lumen 412. In this aspect, fluidcan travel along pathways 212A, 408A to/from the surgical cavity 446, aspreviously discussed. The assembly further includes a second fluidpathway 602B which is separate from the first pathway and includes fluidpathway 212B integrated with the robotic arm link 202E and dockinginterface 208 (e.g., the tool drive side pathway) and fluid pathway 408Bintegrated with the cannula interface 404 (e.g., the cannula sidepathway). Fluid pathway 408B extends between a fluid port 406B at aproximal end of the cannula interface 404 and a fluid port 410B at adistal end of the cannula interface 404. Fluid port 406B is in fluidcommunication with the fluid pathway 212B while fluid port 410B is influid communication with the cannula lumen 412. In this aspect, a fluidcan travel along pathways 212B, 408B to/from the surgical cavity 446, aspreviously discussed. Pathways 602A and 602B may run substantiallyparallel to one another as shown, or may be in any other configurationswhich allow for separate and independent fluid transmission into and/orout of the associated surgical cavity 446.

In the illustrated configuration, pathways 602A and 602B are completelyseparate pathways which allow for different fluids (e.g., a first fluidand a second fluid) or the same fluid to travel to/from the surgicalcavity 446. The fluid(s) may travel in the same or different directions,as desired. For example, the first pathway 602A can be used formaintaining insufflation within surgical cavity 446 and pathway 602B canbe used for smoke evacuation from surgical cavity 446. Representatively,insufflation gas from an associated surgical insufflator (e.g.,insufflator 214 shown in FIG. 2) may flow through the first pathway 602Ain a direction toward cannula 402 (as shown by dashed arrows) fordelivery to the surgical cavity 446. A fluid may also flow through thesecond pathway 602B in the opposite direction (as shown by dashedarrows) to remove the gas, smoke and/or any other fluids or particulatesfrom the cavity 446. In this aspect, the first and second pathway 602A-Bcan be used for active insufflation and smoke and/or particulateevacuation. These operations are considered “active” in that the pump(e.g., surgical insufflator 214) which is connected to both pathways,can be used to drive the direction of fluid flow. These operations maybe performed simultaneously, consecutively, or at other time, asdesired, as will be discussed in more detail in reference to FIG. 10.

In addition, a sterile adapter 414, similar to the sterile adapterpreviously discussed in FIG. 4-FIG. 5, may be positioned between cannulainterface 404 and docking interface 208 to create a sterile barrieraround cannula 402. In this configuration, however, the sterile adapter414 may include first and second adapter openings 418A, 418B toaccommodate the first and second pathways 212A-B, 408A-B and allow forthe transmission of fluid along both pathways to the cannula 402, aspreviously discussed. Filters 428A, 428B may also be positioned betweencannula interface 404 and docking interface 208. Filter 428A may be incommunication with pathways 212A, 408A and filter fluids transmittedthrough pathways 212A, 408A. Filter 428B may be in communication withpathways 212B, 408B and filter fluid transmitted through pathways 212B,408B. One or both of filter 428A-B could be filters which block fluidsor particulates from being transferred between pathways 212A-B andpathways 408A-408B. For example, filter 428B, which is associated withsecond pathway 602B, shown in this configuration as transmitting fluidsaway from the surgical cavity 446 (see arrow), could be a filter whichblocks particulates or other non-sterile matter retrieved from thesurgical cavity from being transmitted from pathway 408B to pathway212B. This configuration allow the robotic side of the pathway (e.g.,insufflation tubing) to be used for an entire day of procedures and onlythe adapter 414 and cannula 402 need to be replaced between patients. Inaddition, seals 416A, 416B for sealing the adapter 414 and/or filters428A-B between the docking and cannula interfaces 208, 404 may furtherbe provided. It is further contemplated that although not shown in FIG.6, one or both of pathways 602A-B may include a nozzle such as thenozzle 440 previously discussed in reference to FIG. 4.

FIG. 7 is a cross-sectional side view of a tool drive and cannulainterface according to another aspect of the invention. The tool driveand cannula interface of FIG. 7 is substantially similar to that of FIG.6 in that it includes a robotic arm link 202E and docking interface 208that connects with, or interfaces with, the cannula interface 404 ofcannula 402 as previously discussed. In addition, the assembly includestwo integrated fluid pathways 602A, 602B for input/output of a fluidbetween the pump (not shown) and cannula 402, and a sterile adapter 414including filters 418A-B, as previously discussed. In thisconfiguration, however, the first pathway 602A extends along the roboticarm to the pump (as shown in FIG. 2), while the second pathway 602B doesnot extend the entire length of the robotic arm to the pump. Rather,second pathway 602B extends out the side of the interface 404.Representatively, pathway 602B may have a distal end 704 connected tocannula lumen 412 and a proximal end 704 that terminates at the dockinginterface 208. The proximal end 704 of the pathway 602B may terminateat, or near, a side 708 of docking interface 208 (instead of theproximal end of the robotic arm 104), and be open to the ambientenvironment. A valve 706 may further be connected to the proximal end704 of pathway 602B to open and close the end, and control thetransmission of fluid between pathway 602B and the ambient environment.The pathways 602A, 602B can be used for insufflation and/or smokeevacuation similar to the pathways described in FIG. 6, except thisconfiguration allows for passive smoke evacuation through pathway 602B.The operation is considered “passive” in that at least one of thepathways, namely pathway 602B, is not connected to the pump (e.g.,surgical insufflator 214) and therefore fluid flow through this pathwayis not directly driven, or otherwise controlled, by the pump.

FIG. 8 is a cross-sectional side view of a cannula according to anotheraspect of the invention. The cannula 402 of FIG. 8 is Substantiallysimilar to that of FIG. 7 in that it includes a cannula interface 404that connects to the docking interface (although not shown for ease ofillustration) as previously discussed. In this aspect, however, theintegrated fluid pathway 408 includes a nozzle 802 for cleaning asurgical tool or instrument 804 inserted through the cannula 402.Representatively, similar to the previously discussed configurations,the fluid pathway 408 in the cannula interface 404 extends from fluidport 406 (e.g., facing the docking interface) to a fluid port 410 to thecannula lumen 412. The fluid port 410 to the cannula lumen 412, however,is positioned near the end of the cannula 402 so that when a fluid istransmitted through pathway 408 and out fluid port 410, it is directedtoward an end of the instrument 804 positioned within the cannula lumen412. In some aspects, the pathway 408 may be formed through the cannulainterface 404 as previously discussed, and extend down the side wall 806of cannula 402, to fluid port 410. For example, pathway 408 may includea portion that is formed by a channel between an interior surface 806A(e.g., a surface defining cannula lumen 412) and an exterior surface806B (e.g., a surface facing the ambient environment) of cannula 402.The fluid port 410 to the cannula lumen 412 may be formed through theinterior surface 806A forming the distal end of cannula 402. In thisaspect, the pathway 408 may be integrated entirely within the cannulainterface 404 and cannula 402. In other aspects, a portion, or portions,of the pathway 408 may be coupled to an exterior surface of theassembly. The end of pathway 408 may further include nozzle 802 to helpdirect the fluid toward the end of the instrument 804. The nozzle 802may be any type of nozzle suitable for directing a fluid. For example,the nozzle 802 may be a narrowed portion of pathway 408, or a separatenozzle attached to the end of pathway 408. A fluid (e.g, an insufflationgas) may then be introduced through pathway 408 and out nozzle 802 sothat it contacts the end of the instrument 804 at a sufficient flow rateto clean particles or the like off the end of the instrument 804.

In addition, in some aspects, a heating element 810 that is operable toheat the fluid (e.g., insufflation gas) traveling through the pathway408 may further be provided. The heating element 810 may, for example,be a heated coil or the like that is part of, or otherwise attached to,the insufflation tube that forms the pathway 408. Alternatively, theheating element 810 could be coupled to, or otherwise part of, thecannula interface 404. Heating of the insufflation gas prior to contactwith the instrument 804 may help to reduce fogging, for example of acamera or endoscope inserted in the cannula, which can sometimes occurin the absence of a heating element.

FIG. 9 is a cross-sectional side view of a cannula according to anotheraspect of the invention. The cannula 402 of FIG. 9 is substantiallysimilar to that of FIG. 8 in that it includes a cannula interface 404that connects to the docking interface (although not shown for ease ofillustration) as previously discussed. In this embodiment, however,cannula interface 404 is shown including two integrated fluid pathways902A and 902B. Pathway 902B is substantially similar to pathway 408 asdiscussed in reference to FIG. 8 and includes the pathway 408A extendingbetween a fluid port 406A (e.g., facing the docking interface) and afluid port 410A at the end of the cannula 402. The additional fluidpathway 408B is the same as the pathway 408 discussed in reference toFIG. 4-FIG. 7. Representatively, pathway 408B extends from fluid port406B facing the docking interface to fluid port 410B near the proximalend of the cannula lumen 412 (e.g., the end that receives the surgicalinstrument). Similar to the previously discussed dual pathwayconfigurations, fluid flow can be switched between pathways 408A-B asdesired. In this configuration, however, since pathway 408A canintroduce a fluid toward the end of an instrument 804 within cannula402, the fluid flow is used for insufflation or cleaning of theinstrument. The selection of the different operations could be triggeredby the operator or automatically depending on whether the instrument 804is retracted into the cannula 402 so that the instrument tip 904 is nearthe nozzle 802. It should further be recognized that instrument 804could be any instrument that may be inserted through the cannula of atrocar during a surgical procedure. For example, the instrument could bean endoscope and the fluid from the nozzle 802 can be used to cleanparticles off the end of the endoscope after a surgical procedure. Inother aspects, the instrument could be a camera and the fluid from thenozzle 802 can be used to remove particles from the camera lens toimprove image quality for the viewer.

It should further be understood that although multiple fluid pathways(e.g., pathways 212, 408, 602A-B, 902A-B) associated with a singlerobotic arm (e.g., arm 104) and cannula (e.g., cannula 402) of thesurgical robotic system 100 are described, it is further contemplatedthat any number of the robotic arms and cannulas of the surgical roboticsystem 100 may include fluid pathways discussed herein. For example, atleast two robotic arm/cannulas of the system 100 may include fluidpathways, and the flow of fluid through each of the pathways may becooperatively controlled to achieve the desired insufflation, smokeevacuation, and/or particulate removal relative to the associatedsurgical cavity. For example, system 100 may include one roboticaim/cannula with one pathway coupled to a surgical insufflator andanother robotic arm/cannula with another pathway coupled to the surgicalinsufflator. During operation, one of the pathways of one of thearm/cannula assemblies may be used to introduce a fluid (e.g,insufflation gas) into the surgical cavity while the pathway associatedwith the other arm/cannula assembly may be used to remove the fluid,smoke, particulate or the like, from the cavity.

In addition, since the surgical insufflator is integrated with, or partof, the surgical robot system 100, the insufflator itself cancommunicate with robot components of system 100 to robotically controlfluid input/output at the surgical site. For example, during surgery,the system detects that it is operating an instrument that createssmoke, such as an energy device. In response, the system canautomatically signal to the surgical insufflator to engage in a smokeevacuation operation and remove smoke from the cavity. The system maydetect operation of the energy emitter based on an input command by theuser, or command by the controller based on a processing protocol input,or a sensor associated with the energy device that emits a signal whenin operation, or some other detection mechanism. For example, thecontroller and/or processor may detect that an energy emitter has beenactuated and send a signal to the pump to turn on/off a smoke evacuationoperation, turn on/off fluid inlet, or other operation to automaticallyachieve a desired insufflation, fluid inflow/outflow or particulateevacuation operation.

In still further aspects, the instrument could include a camera (e.g.,an endoscope camera), which can take images that may show smoke orparticles within the surgical cavity. In this aspect, computer visionmay be used to process the camera images and determine smoke is presentand needs to be evacuated. In response, the controller could signal tothe surgical insufflator to transition to the smoke evacuation mode toremove smoke from the cavity.

The different fluid input/output operations described herein maytherefore be manually controlled by a user (e.g., by a bedside operator108; or remote surgeon 109) or robotically, automatically, or otherwisedynamically, controlled based on a detected surgical condition. FIG. 10is a block diagram of one exemplary process for robotically controllingfluid input/output based on a detected surgical condition.Representatively, process 1000 may include the operation of detecting asurgical condition 1002. The surgical condition may be detected based ona user input, an operation performed during a processing protocol, asignal emitted by a surgical component, a visual analysis, or any otherindicator that a surgical condition is present. Once the surgicalcondition is detected, it is determined whether the surgical conditionis one of any number of conditions. Representatively, the processincludes determining whether the surgical condition is smoke within abody cavity 1004. This condition may be detected, for example, based onan operation of a surgical instrument or device that is known to emitsmoke, such as an energy emitting device, a smoke detection sensorassociated with one or more surgical components in the cavity,processing an image showing smoke within the body cavity, or any othermechanism suitable for smoke detection. Once smoke is detected, or acondition suggesting the presence of smoke is detected, a signal is sentto the surgical insufflator to initiate a smoke evacuation function ormode. For example, the surgical insufflator is actuated to cause a flowof fluid through the integrated fluid pathways (e.g., pathways 212, 408)away from the body cavity, which in turn, will evacuate the smoke fromthe cavity, at operation 1006. In addition, in the case where thesurgical system includes multiple fluid pathways and/or multiplearm/cannula assemblies, the surgical insufflator may cause fluid to flow(e.g., an insufflation gas) through a pathway associated with oneaim/cannula assembly to the body cavity to push the smoke toward anotherfluid pathway which may be in the same arm/cannula assembly orassociated with another aim/cannula assembly. The surgical insufflatorcauses the other fluid pathway to have a reverse direction of fluid flowand draw the fluid away from the body cavity. If, however, smoke is notdetected at operation 1004, the process continues on and determines ifthe surgical condition is actuation of an energy device at operation1008. Since operation of an energy device is known to cause smoke, theprocess then continues to the smoke evacuation operation 1006. If, onthe other hand, actuation of an energy device is not detected atoperation 1008, the process continues to operation 1010 to determine ifparticles are present in the body cavity. The presence of particles maybe detected visually, based on a known operation that generatesparticles, a detected instrument blockage caused by particles, oranother indicator of the presence of particles. If particles aredetected, the surgical insufflator is caused to engage in a particleremoval operation or mode at operation 1012. The particular removaloperation or mode may involve the insufflator causing an outflow offluid through the integrated pathways and away from the body cavity(e.g., to evacuate the particles). Alternatively, where the particlesare detected on a surgical instrument or device, such as the endoscope,the insufflator may cause in an inflow of fluid to the body cavity todrive (e.g., blow) the particles off of the device. If, however,particles are not detected at operation 1010, the process continues onand determines if the condition relates to pneumoperitoneum at operation1014. Pneumoperitoneum refers to the condition where insufflation gas(e.g., carbon dioxide) is introduced into the peritoneal cavity (e.g.,surgical site) to increase the size of the cavity. The gas causes anincrease in pressure within the cavity, and this pressure can bemonitored using pressure sensors associated with the insufflator and/orsurgical system. For example, the pressure sensors can detect a pressurelevel (or changes in pressure level) within the body cavity and thisinformation can be used to monitor whether the pressure level is withina desired range, or otherwise meets a desired threshold level suitablefor the surgical procedure. If a pneumoperitoneum related condition isdetected, for example, a change in pressure level within the surgicalsite or cavity, the surgical insufflator is then actuated and used tocontrol and/or monitor pneumoperitoneum within the body cavity atoperation 1016 so that desired conditions for the surgical operation areconsistently maintained. For example, if the pressure level (or level ofgas within the cavity) are lower than desired, the surgical insufflatormay increase the surgical insufflator may cause a flow of insufflationgas through the integrated pathway(s) to the body cavity. If thepressure level is higher than desired, the surgical insufflator maydecrease the flow of insufflation gas to the body cavity. If none ofthese surgical conditions are determined, process 1000 returns tooperation 1002 and continues to determine whether a surgical conditionrequiring actuation of the surgical insufflator is found. It shouldfurther be understood that any one or more of the previously discussedconditions 1004, 1008, 1010, 1014 may be detected and/or monitored atthe same or different times, and actuation of the surgical insufflatorin response to these conditions as described in operations 1006, 1012,1016 may also be performed at the same or different times.

FIG. 11 is a block diagram of a computer portion of a surgical roboticsystem, which is operable to implement the previously discussedoperations, in accordance with an embodiment. The exemplary surgicalrobotic system 1100 may include a user console 102, a surgical robot120, and a control tower 103. The surgical robotic system 1100 mayinclude other or additional hardware components; thus, the diagram isprovided by way of example and not a limitation to the systemarchitecture.

As described above, the user console 102 may include console computers1111, one or more UIDs 1112, console actuators 1113, displays 1114, footpedals 1116, console computers 1111 and a network interface 1118. Inaddition, user console 102 may include a number of components, forexample, a UID tracker(s) 1115, a display tracker(s) 1117 and a consoletracker(s) 1119, for detecting various surgical conditions required foroperation of the system (e.g., UID orientation, orientation of thesurgeon relative to the display, orientation the console seat, etc). Itshould further be understood that a user or surgeon sitting at the userconsole 102 can adjust ergonomic settings of the user console 102manually, or the settings can be automatically adjusted according touser profile or preference. The manual and automatic adjustments may beachieved through driving the console actuators 1113 based on user inputor stored configurations by the console computers 1111. The user mayperform robot-assisted surgeries by controlling the surgical robot 120using one or more master UIDs 1112 and foot pedals 1116. Positions andorientations of the UIDs 1112 are continuously tracked by the UIDtracker 1115, and status changes are recorded by the console computers1111 as user input and dispatched to the control tower 103 via thenetwork interface 1118. Real-time surgical video of patient anatomy,instrumentation, and relevant software apps can be presented to the useron the high resolution 3D displays 1114 including open or immersivedisplays.

The user console 102 may be communicatively coupled to the control tower103. The user console also provides additional features for improvedergonomics. For example, the user console may be an open architecturesystem including an open display, although an immersive display, in somecases, may be provided. Furthermore, a highly-adjustable seat forsurgeons and master UIDs tracked through electromagnetic or opticaltrackers are included at the user console 102 for improved ergonomics.

The control tower 103 can be a mobile point-of-care cart housingtouchscreen displays, computers that control the surgeon'srobotically-assisted manipulation of instruments, safety systems,graphical user interface (GUI), light source, and video and graphicscomputers. As shown in FIG. 11, the control tower 103 may includecentral computers 1131 including at least a visualization computer, acontrol computer, and an auxiliary computer, various displays 1133including a team display and a nurse display, and a network interface1118 coupling the control tower 103 to both the user console 102 and thesurgical robot 120. The control tower 103 may offer additional featuresfor user convenience, such as the nurse display touchscreen, soft powerand E-hold buttons, user-facing USB for video and still images, andelectronic caster control interface. The auxiliary computer may also runa real-time Linux, providing logging/monitoring and interacting withcloud-based web services.

The surgical robot 120 may include an operating table 1124 with aplurality of integrated robotic arms 1122 that can be positioned overthe target patient anatomy. A suite of compatible tools 1123 can beattached to or detached from the distal ends of the arms 1122, enablingthe surgeon to perform various surgical procedures. In addition, a pump1140 for controlling fluid inflow/outflow of the integrated pathways ofthe arms 112, as previously discussed, may further be included. Thesurgical robot 120 may also comprise control interface 1125 for manualor automated control of the arms 1122, pump 1140, table 1124, and tools1123. The control interface can include items such as, but not limitedto, remote controls, buttons, panels, and touchscreens. Otheraccessories such as trocars (sleeves, seal cartridge, and obturators)and drapes may also be needed to perform procedures with the system. Insome variations, the plurality of the arms 1122 includes four armsmounted on both sides of the operating table 1124, with two arms on eachside. For certain surgical procedures, an arm mounted on one side of thetable can be positioned on the other side of the table by stretching outand crossing over under the table and arms mounted on the other side,resulting in a total of three arms positioned on the same side of thetable 1124. The surgical tool can also comprise table computers 1121 anda network interface 1118, which can place the surgical robot 120 incommunication with the control tower 103.

In the foregoing specification, the invention has been described withreference to specific exemplary embodiments thereof. It will be evidentthat various modifications may be made thereto without departing fromthe broader spirit and scope of the invention as set forth in thefollowing claims. The specification and drawings are, accordingly, to beregarded in an illustrative sense rather than a restrictive sense.

What is claimed is:
 1. A surgical robotic system comprising: a roboticarm; a tool drive coupled to the robotic arm; a cannula interfaceconfigured to couple a cannula to the tool drive, the cannula interfacehaving a fluid pathway in communication with an interior lumen of thecannula; and an insufflation pathway coupled to the robotic arm, theinsufflation pathway having a distal end coupled to the fluid pathwayand a proximal end coupled to a surgical insufflator.
 2. The surgicalrobotic system of claim 1 wherein the fluid pathway is integrated withinthe cannula interface and dimensioned to allow transmission of aninsufflation gas between the insufflation pathway and the interior lumenof the cannula.
 3. The surgical robotic system of claim 1 wherein thetool drive comprises a docking interface and the insufflation pathway iscoupled to the docking interface.
 4. The surgical robotic system ofclaim 1 wherein the interior lumen of the cannula is dimensioned toreceive a surgical tool.
 5. The surgical robotic system of claim 1further comprising a filter in communication with the fluid pathway suchthat an insufflation gas transmitted through the insufflation pathway tothe fluid pathway passes through the filter.
 6. The surgical roboticsystem of claim 5 wherein the filter is integrated into a sterileadapter positioned between the tool drive and the cannula interface. 7.The surgical robotic system of claim 6 further comprising a sealingelement integrated into the sterile adapter to seal the filter betweenthe tool drive and the cannula interface and prevent leakage of theinsufflation gas.
 8. The surgical robotic system of claim 1 wherein thefluid pathway is a first fluid pathway and the insufflation pathway is afirst insufflation pathway, and the surgical robotic system furthercomprises a second fluid pathway coupled to a second insufflationpathway.
 9. The surgical robotic system of claim 8 further comprising avalve coupled to at least one of the first fluid pathway or the secondfluid pathway to control a flow of a fluid through the first fluidpathway or the second fluid pathway.
 10. The surgical robotic system ofclaim 1 further comprising a nozzle coupled to the fluid pathway,wherein the nozzle is configured to direct an insufflation gas flowingthrough the fluid pathway toward a surgical instrument positioned withinthe interior lumen of the cannula.
 11. The surgical robotic system ofclaim 1 wherein the insufflation pathway is an insufflation tube. 12.The surgical robotic system of claim 11 wherein the insufflation tube isenclosed within an outer shell of the robotic arm.
 13. The surgicalrobotic system of claim 11 wherein the insufflation tube is mechanicallyattached to an outer surface of an outer shell of the robotic arm.
 14. Asurgical robotic system comprising: a surgical robotic assembly having arobotic arm, a tool drive and a cannula interface for coupling a cannulato the tool drive, the cannula interface having a fluid pathwayintegrated therein that is in fluid communication with an interior lumenof the cannula; an insufflation tube coupled to the robotic arm, theinsufflation tube having a distal end coupled to the fluid pathway and aproximal end coupled to a surgical insufflator; and a processorcommunicatively coupled to the surgical robotic assembly and thesurgical insufflator, the processor operable to control an operation ofthe surgical insufflator based on a detected surgical condition.
 15. Thesurgical robotic system of claim 14 wherein the detected surgicalcondition comprises a presence of smoke within a surgical site; and theoperation controlled by the processor is a smoke evacuation function ofthe surgical insufflator.
 16. The surgical robotic system of claim 15wherein the smoke evacuation function comprises actively evacuatingsmoke through the insufflation tube while maintaining pneumoperitoneumat the surgical site.
 17. The surgical robotic system of claim 15wherein the fluid pathway is a first fluid pathway and the insufflationtube is a first insufflation tube, and the surgical robotic assemblyfurther comprises a second fluid pathway and a second insufflation tubethat are not fluidly coupled to the surgical insufflator, and the smokeevacuation function comprise passively evacuating smoke through thesecond fluid pathway and second insufflation tube.
 18. The surgicalrobotic system of claim 15 wherein the robotic arm is a first roboticarm and the insufflation tube is a first insufflation tube, the systemfurther comprising a second robotic arm and a second insufflation tubeintegrated with the second robotic arm, and the smoke evacuationfunction comprises introducing a flow of fluid to the surgical cavitythrough the first insufflation tube and evacuating smoke from thesurgical cavity using the second insufflation tube.
 19. The surgicalrobotic system of claim 14 wherein the detected surgical conditioncomprises activation of an energy device within a surgical site; and theoperation controlled by the processor is a smoke evacuation function ofthe surgical insufflator.
 20. The surgical robotic system of claim 14wherein the detected surgical condition comprises a presence ofparticles within a surgical site; and the operation controlled by theprocessor is a particle removal function of the surgical insufflator.